Beyond Intercourse

Now may be the time to learn more about sexual practices other than vaginal intercourse. Sex in America tells us that people do a lot of things besides. Sex isn't just penis in vagina; it's all kinds of other activities, too.

Oral sex

For example, up to 25% of couples between the ages of 30 and 60 regularly engage in oral sex. Maybe oral sex will allow tender parts of you to heal while providing enough gratification to keep you both content. Twenty-five percent is a respectable number, enough to make the practice a normal part of sexuality, enough to give you permission, if that's what you need.

Masturbation

For some, the word itself is enough to induce palpitations. The authors of Sex in America tell us something we all know: Masturbation is a practice that few discuss, that's condemned by many, and that makes some of us feel guilty—but many people, if not most, masturbate. And surprisingly, it's practiced most by people who are otherwise sexually active or married; it stimulates and is stimulated by other sexual behavior.

That men are more avid practitioners than women is no surprise. One reason may be how easy and convenient it is for them; they've got their hands on their penis a few times a day anyway, urinating, and it's a small stretch of the imagination to get something else going.

Women, on the other hand, have to go to greater lengths. You need some place to sit or lie down, you may need some kind of paraphernalia (where do you keep it? what do you do with it afterward?), and you may have to learn technique—and to let go of guilt and inhibition. You will not harm yourself, and nobody will know if you do it or don't. You are in the privacy of your own bedroom and you are entitled to do whatever makes you happy and doesn't hurt anyone else.

Massage

If your sexual response continues to be sluggish, a head-to-toe massage could play an important role in your sexual menu. Manual stimulation using a lubricant can also provide gratification, a welcome substitute during the period of recovery and readjustment. It also allows you to learn more about what pleases you, as well as providing hands-on maneuvering to hot spots, without having to say a word.

Feet are plenty sensual. We abuse them all day long; how nice to give them a little extra attention at night. You'd be amazed at how many women are thrilled by a foot massage. When your lover next wants to do something extra-special for you, ask for a foot rub. Or a plain old back rub—in the good old days, any stay in the hospital guaranteed you a nightly back rub; they knew how therapeutic it was.

Massage is a wonderful relaxant and an aphrodisiac. Give it a whirl, music and body oils included.

Your touching habits

If your breasts were a crucial part of your sex life before your illness, you'll be experiencing new attitudes and sensations:

You may want no touching, more touching, or tentative touching of the breast.

Your partner may want no touching, more touching, or tentative touching.

The treated breast can be sensitive after healing, or painful, or numb.

Women who have lumpectomy are more likely to continue enjoying some breast caressing during sex compared to women who have had mastectomy with breast reconstruction.

If your breast has been reconstructed, it will most likely have dulled sensation or none at all.

You'll have to take hold of the toucher to communicate the touching you do or don't want. You may have to learn to be more assertive than you were before all this. If you can't use words freely, you must use your hand to guide the action, especially if you don't want it going to the breast that is or was. Some women don't want the healthy breast touched any longer because it reminds them too much of the loss of the other.

Although you may feel uncomfortable with breast touching now, later you may change your mind. It may be easier for you to request no touching of your breast area, and for your partner to accept this request, if you indicate that the door isn't slammed shut forever and that you're willing to revisit the possibility later.

Endorphins and exercise

While you're checking out other solutions to your sexual concerns, try to get back to a regular pattern of exercise. Do this gradually, as you feel up to it. Exercise stimulates the production of endorphins, which contribute to your sense of well-being. So exercise has been shown to have a positive effect on a person's sex life. Besides, toning and limbering up your muscles will make you feel better about yourself and proud of your self-discipline. A confident you is a sexier you.

Vicky Cosgrove thinks one reason her sex life didn't falter was that she swam every day, regardless of how she felt. "I think it kept my blood oxygenated enough so I didn't feel that crushing fatigue everyone warned me about," she says.

Speaking of exercise, you may want to try Kegels, exercises that strengthen the pubococcygeal muscle in the lower vaginal area (also known as the love muscle), the muscle that contracts during orgasm. Tense up, as though you're holding back a bowel movement or stopping the flow of urine, then count to five, release, and repeat. You can practice this exercise anywhere; it's your own private activity.

Expert Quote

"Masturbation is a normal form of sexual activity and release. It provides innocent pleasure and keeps your body healthy. I tell my patients it's a form of exercise and conditioning for the vagina—which has suffered considerable change and lack of use during breast cancer treatment."